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Avodart Appetite & Cravings Changes: What the Evidence Actually Shows

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At a glance

  • Drug / dutasteride (Avodart), 0.5 mg capsule once daily [1]
  • Approved use / symptomatic BPH; hair loss is off-label [1]
  • Label adverse reactions / impotence, decreased libido, ejaculation disorders, breast disorders [1]
  • Appetite or cravings in the label / not listed [1]
  • Half-life / about 5 weeks at steady state [1]

Does dutasteride change appetite or cravings?

The Avodart label does not name hunger, appetite or food cravings among the reactions it lists [1]. In the pooled 2-year placebo-controlled BPH trials (2,167 men on Avodart, 2,158 on placebo, mean age 66), reactions over months 0 to 6 were impotence 4.7% vs 1.7%, decreased libido 3.0% vs 1.4%, ejaculation disorders 1.4% vs 0.5% and breast disorders 0.5% vs 0.2% [1]. Postmarketing reports in the label add hypersensitivity reactions, male breast cancer, depressed mood, and testicular pain and swelling [1].

What the trials measured

CombAT randomized 4,844 men aged 50 or older with BPH to dutasteride 0.5 mg, tamsulosin 0.4 mg, or both for 4 years. Its primary endpoint was time to first acute urinary retention or BPH-related surgery, and secondary endpoints included BPH clinical progression, symptoms, peak urinary flow, prostate volume, safety and tolerability [2]. The 24-week hair-loss trial randomized 917 men aged 20 to 50 to dutasteride 0.02, 0.1 or 0.5 mg daily, finasteride 1 mg daily or placebo, and reported that the number and severity of adverse events were similar across groups [3]. Appetite and food cravings are not among the outcomes described for either trial, so these reports cannot show whether dutasteride changes them [2][3].

Dutasteride and finasteride: is there an appetite comparison?

The direct comparison is the 24-week hair-loss trial above, where dutasteride 0.5 mg increased hair count more than finasteride 1 mg and adverse events were similar across groups [3]. A separate meta-analysis of 15 randomized placebo-controlled hair-loss trials (4,495 men) looked at sexual adverse effects: relative risk of sexual dysfunction was 1.37 with dutasteride 0.5 mg (95% CI 0.81 to 2.32, not significant) and 1.66 with finasteride 1 mg [4]. Neither report describes an appetite outcome.

Frequently asked questions

Is appetite change listed as an Avodart side effect?
No. The Avodart label's common reactions are impotence, decreased libido, ejaculation disorders and breast disorders, and its postmarketing reports include hypersensitivity, male breast cancer, depressed mood, and testicular pain and swelling [1].
Does dutasteride cause weight gain?
Weight gain is not among the reactions the Avodart label lists [1]. In the 24-week trial of 917 men, the number and severity of adverse events were similar across dutasteride, finasteride and placebo [3].
Can Avodart make you crave sugar or carbohydrates?
The Avodart label does not list cravings among its adverse reactions [1]. In the pooled BPH trials the common reactions were impotence, decreased libido, ejaculation disorders and breast disorders [1].
How long does dutasteride stay in the body after the last dose?
The terminal half-life is about 5 weeks, and serum levels stay detectable (above 0.1 ng/mL) for up to 4 to 6 months after stopping [1]. The label says men should not donate blood until at least 6 months after the last dose, to avoid giving dutasteride to a pregnant transfusion recipient [1]. How long an appetite change would last, if one occurred, is not described.

References

  1. U.S. National Library of Medicine, DailyMed. Avodart (dutasteride) soft gelatin capsules, Waylis Therapeutics prescribing information. Avodart (dutasteride) soft gelatin capsules, Waylis Therapeutics label
  2. Roehrborn CG, Siami P, Barkin J, Damião R, Major-Walker K, Nandy I, et al. The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from the CombAT study. Eur Urol. 2010;57(1):123-31. The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from the CombAT study
  3. Gubelin Harcha W, Barboza Martínez J, Tsai TF, Katsuoka K, Kawashima M, Tsuboi R, et al. A randomized, active- and placebo-controlled study of the efficacy and safety of different doses of dutasteride versus placebo and finasteride in the treatment of male subjects with androgenetic alopecia. J Am Acad Dermatol. 2014;70(3):489-498.e3. A randomized, active- and placebo-controlled study of the efficacy and safety of different doses of dutasteride versus placebo and finasteride in the treatment of male subjects with androgenetic alopecia
  4. Lee S, Lee YB, Choe SJ, Lee WS. Adverse Sexual Effects of Treatment with Finasteride or Dutasteride for Male Androgenetic Alopecia: A Systematic Review and Meta-analysis. Acta Derm Venereol. 2019;99(1):12-17. Adverse Sexual Effects of Treatment with Finasteride or Dutasteride for Male Androgenetic Alopecia: A Systematic Review and Meta-analysis
Evidence overview for dutasteride: Avodart Appetite & Cravings Changes: What the Evidence Actually Shows